Medicine, Mind and Adolescence 1998, XIII, 1-2
ADOLESCENT
DEPRESSION:
HOW TO COPE WITH TURMOIL AND DEVELOPMENT OF SELF-NEGATIVITY
Bernardo Nardi And Giorgio Pannelli1
HOW TO COPE WITH TURMOIL AND DEVELOPMENT OF SELF-NEGATIVITY
Bernardo Nardi And Giorgio Pannelli1
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Abstract
Aim.
Adolescent mental health protection - helping the adolescent to cope in a positive manner the turmoil related to growth and maturation - is important to give the adolescent adequate tools to become a well-balanced adult. According to the systems and process-oriented cognitive theory, different significant factors are involved in the development of a “self-organization of personal meaning dimension”, such as constitutional factors, attachment relationships, and, most of all, a subjective manner of arranging life experiences. During adolescence, each self-organization of a personal meaning dimension acquires more or less adaptive characteristics that will be used during adulthood. Therefore, in regard to its physiological or pathological aspects, adolescent depression represents a critical way of understanding emotional and cognitive styles involved in the development of adult personality.
Methods.
According to our previous investigations, adolescent depression has been classified into three different patterns. The first one is characterized by an uncertain and indefinite personality, which avoids any significant confrontation (external depression, corresponding to an “entangled”, anxious resistant attachment). The second one is characterized by a primary sense of personal inadequacy and failure (internal depression, corresponding to a “dismissing”, anxious avoiding attachment). The third one has characteristics common to the other two patterns or has atypical clinical aspects. Cognitive psychotherapy, concerning the 151 subjects treated (69 males and 82 females), pointed out the following perturbing events: a) marked feelings of family, affective, school, or work devaluation (Type I depression), b) feelings of subjective negativity, abandonment or loss (Type II depression), and c) various feelings of personal inadequacy, sometimes centered on an ambivalent sense of self.
Results.
Cognitive psychotherapy, performed by reframing subjective negativity themes, according to the self-organization of personal meaning dimension of each adolescent, allowed for a more adaptive and viable reading of one’s own experience over time. In therapy, feelings of self-negativity (perceived as objective and unchanging aspects of the self) were focused as subjective patterns in organizing experiences, giving them the following values: a) not being appreciated by significant other’s opinions (Type I depression), b) maintaining an internal self-devaluation (Type II depression), c) associating feelings of being scarcely appreciated with internal self-devaluation (Type III-a depression, mixed patterns), or d) esteeming themselves as guiltily imperfect (Type III-b depression, ambivalent patterns).
Conclusion.
A specific, precocious and focused intervention on adolescent turmoil, which causes a negative view of the self and the world, has been useful to cope such problems and to avoid any chronicity.
Key Words: adolescence, cognitive psychotherapy, depression, self-organization of personal meaning dimension.
1. Correspondence to: Bernardo Nardi and Giorgio Pannelli, Institute of Psychiatry, University of Ancona, Largo Cappelli 1, 60121 Ancona (Italy)
